The demographics of the U.S. population are undergoing a significant transformation. According to the U.S. Census Bureau, members of the baby boomer population — the 73 million Americans born between 1946 and 1964 — will all reach the age of 65 by 2030. This transition is expected to place substantial pressure on the healthcare system in the coming decades, not only in the efficient delivery of care for the elderly but also regarding the associated costs.
To address the forthcoming elder-care crisis, reforms on many levels are necessary. One of the greatest initiatives has been to increase the number of healthcare workers specializing in geriatric medicine. From physicians and nurses to clinical nurse leaders and personal care aides, expanding these geriatric-focused positions will be necessary to meet the rising demand.
What Are the Major Drivers of the Elder-Care Crisis?
Elderly patients often require more frequent care due to the cumulative effect of decades of chronic and complex comorbidities such as heart disease, dementia and diabetes. The costs, both to the patient and already-burdened Medicare and Medicaid systems, can be exorbitant for outpatient services, testing and medication.
The U.S. Department of Health and Human Services (HHS) estimates that as much as 70% of the aging baby boomer population will need long-term care for an average of three years, either in-home or inpatient. There are many elders in the U.S. without relatives or community members to act as caretakers.
Unfortunately, long-term care is expensive and may be out of reach for many. According to Genworth, a financial services company that provides long-term care insurance, the median monthly cost for home health aide services exceeded $4K in 2020, with a semi-private room at a nursing home facility approaching $8K. Current Medicare and Medicaid guidelines either do not cover these costs or have strict parameters that limit access.
With limited options, care for elders often falls to wary and ill-prepared family members. A May 2020 report by AARP suggests that an estimated 42 million Americans care for an adult aged 50 or older at home, up from 34 million in 2015. These family members often also manage careers, childcare and their own health conditions. Some caretakers must leave the workforce entirely due to the emotional and physical toll of caring for their elders.
How Has the COVID-19 Pandemic Affected Elder-Care?
The pandemic has further complicated the elder-care landscape. Many inpatient and outpatient facilities were unprepared to take aggressive measures to prevent the spread of the virus, resulting in numerous deaths and prompting concerns that ageism played a role in the delays.
Social distancing restrictions have also prevented family members and friends from maintaining close contact with the elderly, whether in their homes or at a facility. Without this social support, older adults have endured additional mental and emotional stress that has likely also affected their vitality.
How Is the U.S. Addressing the Elder-Care Crisis?
Efforts to address the elder-care crisis have picked up steam in recent years and include:
- Encouraging more healthcare workers to specialize in geriatric care;
- Expanding geriatric services and personnel in hospitals, nursing homes, hospices, and home health and personal care agencies;
- Introducing legislation, at the state and federal levels, to make long-term care insurance plans more affordable, provide training and reimbursement to family caregivers and increase the number of in-home care options; and
- Improving coordination of care for older patients, whether they are aging in place or a nursing home, as well as increasing oversight of elder-care facilities.
Caring for the Nation's Elderly
By 2030, nearly one-quarter of the U.S. population will be aged 65 or older and require more frequent and advanced levels of care. To reduce the anticipated strain on the healthcare system, experts advocate for a greater emphasis on geriatric care, including expanding accessible services, boosting the number of dedicated geriatric healthcare workers and supporting family caregivers.
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